Dr. Reginald Silver Dr. Antonis Stylianou Dr. Chandra Subramaniam. Patient Portal Usage: A Study of Antecedents and Patient Outcomes

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1 Dr. Reginald Silver Dr. Antonis Stylianou Dr. Chandra Subramaniam Patient Portal Usage: A Study of Antecedents and Patient Outcomes

2 2 Background Patient portals are web-based services or mobile applications that patients can log and view Personal health information Schedule appointments Order prescriptions refills Pay medical bills Exchange secure communication with their healthcare providers

3 3 Benefits and Usage of Portals Healthcare providers who use patient portals can Improve efficiency by expediting communication with patients and billing for services Improve effectiveness of care Presumably, patients who are engaged in their health care and are better educated could positively impact their health outcomes Such a win-win technology would be expected to have high rates of adoption and usage However, several studies have found between 30%-50% of patients access and use portals

4 4 Current Understanding Many studies on patient portals use technology acceptance models (TAM) to understand the factors which influence intention to adopt portals Few studies which have investigated real portal usage are descriptive Some results from these descriptive studies are Portal usage is influenced by age and gender Portal usage is influenced by behavioral intention and habit Portal usage is not moderated by race No study yet that looks at the data on portal access and usage stored on the portal systems themselves

5 5 Research Questions Combining the objective data from portal web logs with surveying the patients about their motivations and perceptions will help us Understand the real drivers of patient portal usage Determine the impact of usage on patient satisfaction and health outcomes

6 6 Theoretical Model

7 7 Phase 1 Data Collection Elements Demographic Data Biometric Data Usage Data Health Status Age Primary Frequency of Use ICD-10 Codes Diagnosis Sex Height Portal Features Acuity Scores Accessed Race Weight Extent of Use Healthy Days Educational Level Body Mass Episodic Duration of Readmissions Index Use Zip Code HDL Activation Date Marital Status LDL Employment Status Total Cholesterol Primary Physician Glucose ID Attending Physician Blood Pressure ID Facility/Practice ID

8 8 Phase 1 Data Collection Elements (continued) Health Behaviors Intent to Change Self-Assessment Smoking Status Smoking Physical Health Alcohol Exercise Mental Health Consumption Sleeping Habits Stress Level Work Absences Seatbelt Use Diet Family History Fire Prevention Weight Patient-reported Outcome Score(s) Dietary Habits Compliance With Medical Advice Exercise Sleeping Habits

9 9 Phase 2 Data Collection: Survey Questions Construct from Theoretical Abbreviation Survey Item Model Social Influence SI People that care for me want me to use the portal People that influence me want me to use the portal My nurse or physician has encouraged me to use the portal Habit H Portal usage has become a habit for me I must use the portal on a regular basis to improve my health Facilitating Conditions FC I have access to a device that connects to the Internet I know how to access the portal The portal works with other technology that I use Ease of Use EU Learning to use the patient portal was easy for me The portal is easy to navigate and use Performance Expectancy PE Using the portal will support the care I receive Using the portal allows me to be more involved in my own care

10 10 Survey Questions (continued) Construct from Theoretical Model Abbreviation Survey Item Perceived Vulnerability PV I believe I am vulnerable to illnesses I believe that I am not likely to suffer from most illnesses that other people get Perceived Severity PS I believe that my current health conditions are serious Satisfaction with Portal SWP I am satisfied with the patient portal I would recommend using the portal to my friends and family Health Seeking Behavior HSB Portal usage has influenced me to exercise more Portal usage has influenced me to adopt healthier behaviors Perceived Health Outcomes PHO Portal usage has contributed to me being in better health

11 11 Research Partnerships Ongoing effort Currently Actively collaborating with major university health center Advanced stage of discussions with a regional health provider Advanced stage of discussions with a cancer hospital Seeking additional partnerships!!

12 12 Benefits of Participating in this Study Better understanding of how patients use portals Educate patients on benefits of portal usage Better portal design Leading to: Increased and more effective usage More efficient usage Increased active patient engagement Increased patient satisfaction Improved health outcomes

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